Healthcare Provider Details

I. General information

NPI: 1376523829
Provider Name (Legal Business Name): CHERYL BRODSKY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 06/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 WHIPPLE ST
N ATTLEBORO MA
02760-3621
US

IV. Provider business mailing address

35 LORIMER AVE
PROVIDENCE RI
02906-3604
US

V. Phone/Fax

Practice location:
  • Phone: 508-695-9977
  • Fax:
Mailing address:
  • Phone: 401-331-6980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number77497
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: